Clinical review for general practice

ISSN (Print) 2713-2552
ISSN (Online) 2782-5671
  • Home
  • about
  • archives
  • contacts
left
FULLSCREEN > Archive > 2025 > Vol 6, №1 (2025) > Safety of short-acting beta-2-adrenomimetics: clinical observations and literature review

Safety of short-acting beta-2-adrenomimetics: clinical observations and literature review

Guzel M. Bikkinina , Gulnaz U. Makarova , Yana A. Tiushevskikh , Ekaterina O. Sobianina , Iliuza I. Narynbaeva , Radik F. Gatiyatullin , Yulia N. Khamatkhanova , Olesya V. Shamsheeva

For citation:


  • Abstract
  • About the Author
  • References

Abstract

Introduction. In modern clinical practice, one of the most important aspects of treatment is the safety of pharmacotherapy, which emphasizes the need for careful monitoring of the safety of drug use and patient education. Advances in medicine are associated with the creation and use of highly effective drugs. Along with this, the problem of drug safety has become one of the most pressing health problems in recent years. This article provides an analysis of clinical cases of the development of complications in patients who used inhaled β2-adrenergic agonists in violation of the instructions for use. The article presents cases of patients using inhaled β2-adrenomimetics. The etiology, clinical picture, diagnosis and treatment methods are presented in the framework of not only clinical observation of patients, but also literature data, with the aim of improving the understanding of patient management tactics.
Material and methods. An analysis of the medical documentation of patients with exacerbation of severe bronchial asthma who were undergoing inpatient medical treatment at the State Budgetary Institution of the Russian Children's Clinical Hospital of the Republic of Bashkortostan in Ufa from September to November 2023 was carried out. The authors searched for publications in electronic databases PubMed, Web of Science, Google Scholar and ELibrary. The search was conducted using the following keywords and their combinations: "beta-2-adrenomimetics", "safety of pharmacotherapy, beta", "dosage regime", "bronchial asthma", "pneumothorax", "beta 2-agonists", "clinical case". All works were published in the period from 2007 to 2023.
Results and discussion. The main errors in the pharmacotherapy of bronchial asthma, which resulted in severe complications, were identified. Correction of treatment and asthma school for patients were carried out. Possible reasons for the individual response to treatment with β2-agonists and the development of unwanted side effects are suggested. Ways to prevent such complications are proposed.
Conclusions. We have identified factors affecting the safety of the use of β2-adrenergic agonists, such as violation of the dosage regimen, lack of basic therapy, and low patient compliance.
Keywords: safety of pharmacotherapy, beta 2-agonists, dosing regimen, clinical case, adolescence, pneumothorax.

About the Author

Guzel M. Bikkinina 1 , Gulnaz U. Makarova 2 , Yana A. Tiushevskikh 1 , Ekaterina O. Sobianina 1 , Iliuza I. Narynbaeva 1 , Radik F. Gatiyatullin 1 , Yulia N. Khamatkhanova 3 , Olesya V. Shamsheeva 3

1 Bashkir State Medical University, Ufa, Russia

2 Bashkir State Medical University, Ufa, Russia; Republican Children's Clinical Hospital, Ufa, Russia

3 Republican Children's Clinical Hospital, Ufa, Russia

References

1. Терехов Д.В. Тяжелая неаллергическая бронхиальная астма: характеристика фенотипа и особенности лечения. Астма и аллергия. 2019;3:3-7.
Terekhov D.V. Severe non-allergic bronchial asthma: characteristics of the phenotype and treatment features. Asthma and allergy. 2019;3:3-7 (in Russian).
2. Chuchalin AG, Khaltaev N, Antonov NS et al. Chronic respiratory diseases and risk factors in 12 regions of the Russian Federation. Int J Chron Obstruct Pulmon Dis 2014;9:963-74. DOI: 10.2147/ COPD.S67283
3. GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study. Lancet. 2020;396(10258):1204–1222. DOI: 10.1016/S0140-6736(20)30925-9
4. Быстрицкая Е.В., Биличенко Т.Н. Обзор общей заболеваемости населения Российской Федерации бронхиальной астмой. Пульмонология. 2022;32(5):651-60. DOI: 10.18093/0869-0189-2022-32-5-651-660
Bystritskaya E.V., Bilichenko T.N. The review of the bronchial asthma morbidity in the population of the Russian Federation. Pulmonologiya. 2022;32(5):651-60. DOI: 10.18093/0869-0189-2022-32-5-651-660 (in Russian).
5. Muneswarao J, Hassali MA, Ibrahim B et al. It is time to change the way we manage mild asthma: an update in GINA 2019. Respir Res 2019;20(1):183. DOI: 10.1186/s12931-019-1159-y
6. DynaMed. Beta-2 Agonist Toxicity – Emergency Management. EBSCO Information Services.
7. Abosamak NR, Shahin MH. Beta2 Receptor Agonists and Antagonists. In: StatPearls. Treasure Island (FL): StatPearls.
8. Tester AA, Logan S, Pollock L, McKie A. Clenbuterol: a new toxic substance in paediatrics. BMJ Case Rep 2020;13(3):e233180. DOI: 10.1136/bcr-2019-233180
9. Lan K, Saheba A, Mathew P. Low Dose Clenbuterol Toxicity: Case Report and Review of Literature. HCA Healthc J Med 2020;1(4):201-4. DOI: 10.36518/2689-0216.1086
10. Sharif Z, Al-Alawi M. Beware of beta! A case of salbutamol-induced lactic acidosis in severe asthma. BMJ Case Rep 2018;2018:bcr201 7224090. DOI: 10.1136/bcr-2017-224090
11. Phoophiboon V, Singhagowinta P, Boonkaya S, Sriprasart T. Salbutamol-induced lactic acidosis in status asthmaticus survivor. BMC Pulmonary Medicine 2021;21(1):23. DOI: 10.1186/s12890-021-01404-x
12. Баранова И.А. В2-агонисты при бронхиальной астме: вопросы эффективности и безопасности. Практическая пульмонология. 2007;3:29-33.
Baranova I.A. B2-agonists in bronchial asthma: questions of effectiveness and safety. Practical pulmonology. 2007;3:29-33 (in Russian).
13. Молостова Т.Н. Генетические различия 2-адренорецепторов и их клиническое значение. Практическая пульмонология. 2017;2:63-71.
Molostova T.N. Genetic differences of 2-adrenoceptors and their clinical significance. Practical pulmonology. 2017;2:63-71 (in Russian).
14. Павлова К.С., Мдинарадзе Д.С., Кофиади И.А., Курбачева О.М. Роль генетических полиморфизмов β2-адренорецептора в фармакологическом ответе на терапию бронхиальной астмы. Российский аллергологический журнал. 2019;16(1):13-22. DOI: 10.36691/RJA16
Pavlova K.S., Mdinaradze D.S., Kofiadi I.A., Kurbacheva O.M. The role of genetic polymorphisms of the β2-adrenoceptor in the pharmacological response to the therapy of bronchial asthma. Russian Allergological Journal. 2019;16(1):13-22. DOI: 10.36691/RJA16 (in Russian).
15. Брянцева О.Н., Тихомиров Е.Е., Журкова Н.В. и др. Полиморфизм гена β2-адренергического рецептора и эффективность бронхолитической терапии у детей с бронхиальной астмой. Педиатрическая фармакология. 2007;4(3):35-9.
Bryantseva O.N., Tikhomirov E.E., Zhurkova N.V. et al. β2-adrenergic receptor gene polymorphism and effectiveness of broncholytic therapy in children with bronchial asthma. Pediatric pharmacology. 2007;4(3):35-9 (in Russian).
16. Warraich S, Bush A, Levy ML, Fleming L. Regular (up to 10 puffs
4-hourly) inhaled salbutamol should be prescribed at discharge after an asthma attack: myth or maxim? Breathe (Sheff) 2023;19(3):230054. DOI: 10.1183/20734735.0054-2023
17. Al Zaabi A, Busaidi N, Al Mutairy S et al. Overprescription of short-acting β2-agonists is associated with poor asthma symptom control: results from five Middle Eastern countries included in the SABINA International (III) study. Expert Rev Respir Med 2022;16(7):833-47. DOI: 10.1080/17476348.2022.2099841
18. Montero-Arias F, Garcia JCH, Gallego MP et al. Over-prescription of short-acting β2-agonists is associated with poor asthma outcomes: results from the Latin American cohort of the SABINA III study. J Asthma 2023;60(3):574-87. DOI: 10.1080/02770903.2022.2082305
19. Khattab A, Madkour A, Ambaram A et al. Over-prescription of short-acting β2-agonists is associated with poor asthma outcomes: results from the African cohort of the SABINA III study. Curr Med Res Opin 2022;38(11):1983-95. DOI: 10.1080/03007995.2022.2100649
20. de Las Vecillas L, Quirce S. Landscape of short-acting beta-agonists (SABA) overuse in Europe. Clin Exp Allergy 2023;53(2):132-44. DOI: 10.1111/cea.14250
21. Wang HC, Djajalaksana S, Sharma L et al. Evaluation of short-acting Beta-2-agonist prescriptions and associated clinical outcomes: Findings from the SABA use IN Asthma (SABINA) study in Asia. World Allergy Organ J 2023;16;16(10):100823. DOI: 10.1016/j.waojou.2023.100823
22. Bateman ED, Price DB, Wang HC et al. Short-acting β2-agonist prescriptions are associated with poor clinical outcomes of asthma: the multi-country, cross-sectional SABINA III study. Eur Respir J 2022;59(5):2101402. 10.1183/13993003.01402-2021
23. Al-Jahdali H, Wali S, Albanna AS et al. Overprescription of short-acting β2 -agonists among patients with asthma in Saudi Arabia: Results from the SABINA III cohort study. Clin Respir J 2022;16(12):812-25. DOI: 10.1111/crj.13553
24. Yorgancýoðlu A, Aksu K, Naycý SA et al. Short-acting β2-agonist prescription patterns in patients with asthma in Turkey: results from SABINA III. BMC Pulm Med 2022;22(1):216. DOI: 10.1186/s12890-022-02008-9
25. Quint JK, Arnetorp S, Kocks JWH et al. Short-Acting Beta-2-Agonist Exposure and Severe Asthma Exacerbations: SABINA Findings From Europe and North America. J Allergy Clin Immunol Pract 2022;10(9):2297-309.e10. DOI: 10.1016/j.jaip.2022.02.047
26. Nwaru BI, Ekström M, Hasvold P. Overuse of short-acting β2-agonists in asthma is associated with increased risk of exacerbation and mortality: a nationwide cohort study of the global SABINA programme. Eur Respir J 2020;55:1901872. DOI: 10.1183/13993003.01872-2019
27. Vähätalo I, Lehtimäki L, Tuomisto LE et al. Long-Term Use of Short-Acting β2-Agonists in Patients With Adult-Onset Asthma. J Allergy Clin Immunol Pract 2022;10(8):2074-83.e7. DOI: 10.1016/j.jaip.2022. 03.027
28. Amin S, Soliman M, McIvor A et al. Usage Patterns of Short-Acting β2-Agonists and Inhaled Corticosteroids in Asthma: A Targeted Literature Review. J Allergy Clin Immunol Pract 2020;8(8):2556-2564.e8. DOI: 10.1016/j.jaip.2020.03.013
29. Lobuteva L, Lobuteva A, Zakharova O et al. The modern Russian pharmaceutical market: consumer attitudes towards distance retailing of medicines. BMC Health Serv Res 2022;22(1):582. DOI: 10.1186/s12913- 022-07991-7
30. Loh ZC, Hussain R, Balan S et al. Perceptions, attitudes, and behaviors of asthma patients towards the use of short-acting β2-agonists: A systematic review. PLoS One 2023;18(4):e0283876. DOI: 10.1371/journal.pone.0283876
31. Loh ZC, Hussain R, Ong SC et al. Over-the-counter use of short-acting beta-2 agonists: a systematic review. J Pharm Policy Pract 2023;16(1):119. DOI: 10.1186/s40545-023-00627-z
32. Чучалин А.Г., Авдеев С.Н., Айсанов З.Р. и др. Бронхиальная астма: федеральные клинические рекомендации по диагностике и лечению. Пульмонология. 2022;32(3):393-447. DOI: 10.18093/0869-0189-2022-32-3-393-447
Chuchalyn A.G., Avdeev S.N., Aisanov Z.R. et al. Bronchial asthma: federal clinical recommendations for diagnosis and treatment. Pulmonology. 2022;32(3):393-447. DOI: 10.18093/0869-0189-2022-32-3-393-447 (in Russian).

For citation:G.M. Bikkinina, Makarova G.U., Tiushevskikh I.A., Sobianina E.O., Narynbaeva I.I., Gatiyatullin R.F., Khamatkhanova Yu.N., Shamsheeva O.V. Safety of short-acting beta-2-adrenomimetics: clinical observations and literature review. Clinical review for general practice. 2025; 6 (1): 113–120 (In Russ.). DOI: 10.47407/kr2024.6.1.00559


All accepted articles publish licensed under a Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.

  • About
  • Editorial board
  • Ethics
  • For authors
  • Author fees
  • Peer review
  • Contacts

oa
crossref
анри


  Indexing

doaj
elibrary

Address of the Editorial Office:

127055, Moscow, s/m 37

Correspondence address:

115054, Moscow, Zhukov passage, 19, fl. 2, room XI


Managing Editor:

+7 (495) 926-29-83

id@con-med.ru